Pathology/Lab Coding Alert

Question: What is the proper ICD-9 code when the lab performs a urine drug test?

Tennessee Subscriber

Answer: ICD-9 does not provide one specific code for a urine drug test. The correct diagnosis code to report when billing for the lab test depends on the signs, symptoms, patient condition, or other reason for the test, such as screening. The ordering physician will assign a narrative diagnosis or ICD-9 code when requesting a urine drug test from the lab.

For example: A high school student previously diagnosed as marijuana dependent is doing poorly in school. Suspecting marijuana use again, the physician orders a urine drug screen. In this case, the most appropriate code is 304.30 (Cannabis dependence, unspecified).

In another case: A physician might order a general screening urine drug test such as 80100 (Drug screen, qualitative; multiple drug classes chromatographic method, each procedure) for an  elderly patient prior to admission to a nursing home. Because the patient has no known history of drug abuse and shows no signs or symptoms of drug dependence or withdrawal, you should list

V70.3 (Other medical examination for administrative purposes) and V72.62 (Laboratory examination ordered as part of a routine general medical examination) as the reasons for the test.

-- Reader Questions and You Be the Coder were prepared with the assistance of R.M. Stainton Jr., MD, president of Doctors' Anatomic Pathology Services in Jonesboro, Ark.